The guest: EFAS, more efficient for patients and premiums

It is the most important health system reform of the decade. Not so much for its content as for its effects: more efficient care for patients, for health costs and premiums. There are few occasions where everyone can have such a strong impact. Let’s support uniform funding on November 24.

This financial reform will actually enable more modern medical interventions. Currently, any treatment requiring a hospital stay (stationary) is financed 55% by the Canton, 45% by health insurance. All other (ambulatory) care is covered 100% by the health insurance and therefore the premium payers. However, thanks to technical progress, more and more interventions are carried out on an outpatient basis. This solution, lighter, is half as expensive, according to an initial observation by the OFSP in 2019. However, if the transfer from stationary to outpatient care is more judicious overall, it is not satisfactory for policyholders. because it only affects premiums.

The reform proposes to standardize the financing of all care, and to establish participation by the cantons in ambulatory care, according to a single distribution key. At least 440 million francs could be saved. This will unload the premiums.

Favoring outpatient interventions, when indicated for the patient, is beneficial for their well-being. Technical progress allows less invasive interventions, without loss of quality. Outpatient care also avoids the constraints of the hospital: the patient can return home the same evening. And the risks are reduced, both in terms of nosocomial infection and circulatory incidents linked to hospital bed rest. This development obviously requires an adaptation of the organization of caregivers and postoperative follow-up. This financing reform will also promote the quality of patient care: it puts individual financial interests second and will facilitate greater coordination between different health professionals. The patient’s medical journey will become more coherent, and duplicate or unnecessary steps will be better avoided.

Strong support

In certain countries such as Canada, 80% of elective operations take place on an outpatient basis, compared to 20% here. Switzerland must catch up.

The reform enjoys strong support, both in the world of health, among doctors, nurses, hospitals, pharmacies, health insurers, and in politics, where it has many supporters in all parties, only the PS ‘being expressed against. She obtained a large majority in the federal parliament.

After fifteen years of discussions, such convergence is rare and deserves all our mobilization to make it a reality.

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